| John L Otis M D & Michele A Stewart M D Inc | |
|
4150 Regents Park Row 250 La Jolla CA 92037-9124 | |
| (858) 457-2180 | |
| (858) 457-2194 |
| Full Name | John L Otis M D & Michele A Stewart M D Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4150 Regents Park Row, La Jolla, California |
| Authorized Official Name and Position | John Lee Otis (OWNER) |
| Authorized Official Contact | 6195798745 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| John L Otis M D & Michele A Stewart M D Inc 1679 E Main St 205 El Cajon CA 92021-5212 Ph: (619) 579-8745 | John L Otis M D & Michele A Stewart M D Inc 4150 Regents Park Row 250 La Jolla CA 92037-9124 Ph: (858) 457-2180 |
| NPI Number | 1417980939 |
|---|---|
| Provider Enumeration Date | 07/08/2006 |
| Last Update Date | 12/22/2010 |
| Medicare PECOS PAC ID | 3678635109 |
|---|---|
| Medicare Enrollment ID | O20081217000585 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417980939 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | John L Otis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235154535 PECOS PAC ID: 7911180732 Enrollment ID: I20110331000585 |
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